Individual provider Active NPI

Ceciley Jeanne Maxa, DC

  • Chiropractor
  • Savage, MN
National Provider Identifier
1639963127
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7322 Issued in MN
Practice address
6001 Egan Dr Ste 120
Savage, MN 55378-4910
Phone
(952) 440-4553
Fax
(952) 440-4573
NPI assigned
Apr 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7322 MN Primary

Addresses

Primary practice location

6001 Egan Dr Ste 120
Savage, MN 55378-4910

Mailing address

13914 Lupine TRL NE
Prior Lake, MN 55372-2884
Phone (715) 220-8004

Other names 1

  • Ceciley Jeanne Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7322MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Watkins Family Chiropractic PA CurrentSince Apr 13, 2025 Accepting new patients

Locations

6001 Egan Dr
Ste 120
Savage, MN 55378
Phone (952) 440-4553

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1639963127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13914 LUPINE TRL NE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722884",
            "telephone_number": "715-220-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 EGAN DR STE 120",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553784910",
            "telephone_number": "952-440-4553",
            "fax_number": "952-440-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXA",
        "first_name": "CECILEY",
        "middle_name": "JEANNE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "7322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CECILEY",
            "last_name": "JOHNSON",
            "middle_name": "JEANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Savage, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.